Improving burnout and well‑being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum

With growing resident burnout, Accreditation Council for Graduate Medical Education issued new requirements for program interventions to optimize resident well‑being. Little evidence exists on how to best teach resiliency to residents. This study assesses the impact of both a grassroots intervention and formal resiliency curriculum on resident burnout and well‑being.

From November 2016 to August 2017, residents in a large Internal Medicine Residency Program participated in grassroots wellness interventions from the resident‑led Gator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated in a formal program‑driven resiliency curriculum. Wellness interventions included monthly morning reports, bimonthly workshops, and biannual noon conferences. Pre‑ and postintervention Maslach Burnout Inventory (MBI) and Physician Well‑Being Index (PWBI) assessed the effect of both interventions on resident burnout and well‑being. Statistical analyses used Student’s t‑test, Fisher’s exact tests, and linear regression model.

One hundred and twenty‑two residents participated in grassroots interventions. One hundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBI scores for all three sections did not differ between pre ‑and postgrassroots intervention (emotional exhaustion [EE] P = 0.46; depersonalization [DP] P = 0.43; personal accomplishment [PA] P = 0.73]) or between pre‑ and postcurriculum (EE P = 0.20; DP P = 0.40; PA P = 0.51). Students scored higher burnout levels compared to residents in EE (P = 0.001) and PA (P = 0.02). Pre‑ versus postcurriculum PWBI scores did not differ among residents (P = 0.20), while PWBI scores improved among students (P = 0.01).

This study found no improvement in resident burnout or well‑being from a bottom‑up and top‑down approach. Our results imply the need for an early wellness curriculum to improve student well‑being given their higher level of burnout. System‑wide efforts are vital to combat physician burnout.